April 22, 2014

Dr. Mackay featured in Time Magazine article on MERS

The worries are aggravated by the performance of the Saudi government, which has failed to confirm whether the virus is, in fact, mutating. The Saudis have either not performed tests that would reveal the changes, or have not shared them with international authorities, virologists complain. On Monday, Health Minister Abdullah al-Rabiah was fired amid mounting criticism of the kingdom’s handling of the budding crisis.

“It’s frustrating,” says Ian Mackay, an associate professor at the Australian Infectious Diseases Research Institute at the University of Queensland, who compared the Saudi handling of MERS with China’s response to the 2013 outbreak of avian flu. “With the H7N9 virus, China provided almost too much information. You worried about the privacy of some of the patients, given the level of detail that China was providing.

“But we’re seeing the complete opposite extreme in Saudi Arabia, where you can’t even get the sex of the patient in some cases,” Mackay tells TIME. “And the WHO doesn’t seem to be getting that information either.”

Indeed, the World Health Organization as good as confirmed it did not have the latest information from Riyadh in declining to comment on the outbreak on Tuesday afternoon.

“Kindly be advised that we cannot comment on latest MERS figures since we do not have the latest case count,” the WHO’s media office said an e-mailed reply to questions from TIME. “And we can only communicate and comment on the cases that we have been officially notified of by a member state, namely Saudi Arabia.”

Concerns that the virus may have mutated are focused on two clusters of cases among health care workers: One cluster is in Jeddah, the western Saudi city through which pilgrims pass en route to nearby Mecca. The other cluster is among paramedics in Abu Dhabi, in the United Arab Emirates.

Mackay, who noted the clusters in his blog, says he can see two possible explanations: “One is a fairly bad but widespread breakdown of infection control and prevention protocols” among the health care workers—that is, nurses or doctors failing to use gloves, surgical masks or other standard measures designed to prevent infection while working with a MERS patient. Such a breakdown would be possible even in a well-equipped and prosperous Gulf nation, Mackay noted, but for both outbreaks to take place at the same time “would be fairly coincidental.”

The other, more alarming possibility? “The other avenue is the virus has changed and become more easily transmitted between humans,” Mackay said.

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The worries are aggravated by the performance of the Saudi government, which has failed to confirm whether the virus is, in fact, mutating. The Saudis have either not performed tests that would reveal the changes, or have not shared them with international authorities, virologists complain. On Monday, Health Minister Abdullah al-Rabiah was fired amid mounting criticism of the kingdom’s handling of the budding crisis.

“It’s frustrating,” says Ian Mackay, an associate professor at the Australian Infectious Diseases Research Institute at the University of Queensland, who compared the Saudi handling of MERS with China’s response to the 2013 outbreak of avian flu. “With the H7N9 virus, China provided almost too much information. You worried about the privacy of some of the patients, given the level of detail that China was providing.

“But we’re seeing the complete opposite extreme in Saudi Arabia, where you can’t even get the sex of the patient in some cases,” Mackay tells TIME. “And the WHO doesn’t seem to be getting that information either.”

Indeed, the World Health Organization as good as confirmed it did not have the latest information from Riyadh in declining to comment on the outbreak on Tuesday afternoon.

“Kindly be advised that we cannot comment on latest MERS figures since we do not have the latest case count,” the WHO’s media office said an e-mailed reply to questions from TIME. “And we can only communicate and comment on the cases that we have been officially notified of by a member state, namely Saudi Arabia.”

Concerns that the virus may have mutated are focused on two clusters of cases among health care workers: One cluster is in Jeddah, the western Saudi city through which pilgrims pass en route to nearby Mecca. The other cluster is among paramedics in Abu Dhabi, in the United Arab Emirates.

Mackay, who noted the clusters in his blog, says he can see two possible explanations: “One is a fairly bad but widespread breakdown of infection control and prevention protocols” among the health care workers—that is, nurses or doctors failing to use gloves, surgical masks or other standard measures designed to prevent infection while working with a MERS patient. Such a breakdown would be possible even in a well-equipped and prosperous Gulf nation, Mackay noted, but for both outbreaks to take place at the same time “would be fairly coincidental.”

The other, more alarming possibility? “The other avenue is the virus has changed and become more easily transmitted between humans,” Mackay said.